Posts Tagged ‘1Care

FEB 15 — After handing out one-off payments of RM500 to the poor, the government turns around and is now asking for a handout from the taxpayers, under the guise of paying for an improved healthcare system.

The people must now realise that this is a government that has neither the vision nor the will to move Malaysia forward in the global marketplace. After a lousy victory in 2008 general elections, the Barisan Nasional (BN) government has virtually been on a re-election campaign mode since, devising short-term populist agendas such as KR1M, BR1M, etc., none of which addresses the current malaise the country is facing — stagnant wages in the face of rising costs in the midst of a long-drawn out, slow global growth.

As it stretched out is left hand to hand out cash to poor households, its right hand is dipping into the pockets of ordinary Malaysians to fund its lavish spending and greedy cronies.

This is a government that, after half a century in power, actually praises itself as a “caring” government as it hands out a pittance to poor Malaysians, when it should be ashamed that for a country so blessed with natural resources and talent, we still have three-quarters of households with monthly incomes below RM3,000.

This is the same government that that forked out RM80 million to a foreign media outfit to boost its credentials, and the result was an embarrassing worldwide public relations disaster for Malaysia.

This is the same government that sees no wrong doing in lending out RM250 million of the people’s hard-earned money to a Cabinet minister’s family, one with no experience or credentials, to run a national project in which the 31-year-old CEO-son duly demonstrated his superior “cow management” skills by purchasing luxury multi-million condominiums. At the same time, the government has to resort to sticking its crummy hands into our retirement funds in order to come up with an initial RM300 million to help fund homes for poor families.

This is the same government that does not blink an eye when its naval defence procurements overshot its budget by billions, as it prepares to fight its imaginary enemies in the high seas, when the real pirates are running wild inland, hand-in-hand with their BN masters, grabbing projects, concessions and sweet deals.

This is the same government whose ministers live in posh mansions in Damansara Heights, send their kids to private schools or foreign universities, and travel around in chauffeur-driven German cars. Meanwhile, the average Malaysian can barely afford his first terrace house, worries about declining education standards in his children’s schools’, and drives an overpriced local car on overpriced and congested tolled roads.

And now with 1 Care, Malaysians are now asked to fork out more of our incomes so that the government can provide us with a better healthcare system. Instead of looking hard at its books, coming up with ways to trim excess and wasteful spending, and re-prioritising spending towards health and education, the government took the rather lazy and predictable route — more tax on Malaysians.

This is from a government that has given Malaysia its biggest national debt in decades. This is from a government who claims to understand the average Malaysian’s daily tribulations in the face of the current economic uncertainty.

This is from a government that is surely disconnected from the realities that we are facing. When it has the audacity to ask the people to pay more tax to feed its out-of-control spending frenzy that yields no long-term benefit to the country, but are more likely to fatten the bank accounts of well-connected individuals.

KUALA LUMPUR, Feb 18 — The Citizens’ Healthcare Coalition (CHC) has blamed Tun Dr Mahathir Mohamad for the country’s escalating cost of healthcare, linking this to sweeping healthcare reforms pushed through by the former prime minister during the 1980s.

CHC, a coalition of medical practitioners and consumer associations formed recently to protest against 1 Care, cited the corporatisation of the National Heart Institute (IJN) as an example and said it has become one of the country’s costliest specialist centres.

It claimed that waiting time for the needy and poor have become “inordinately long” at the institute and could go up to two years, while those who can afford it could pay to get their treatment overnight.

“This is what privatisation does and we can credit Tun Mahathir for this dismal state of affairs,” CHC representative Dr T. Jayabalan said in a statement here.

He added that in 1994 during Dr Mahathir’s tenure, pharmaceutical services were also privatised, but with the government becoming a stakeholder.

“Along with the privatisation came a 15-year monopoly for pharmaceutical supplies to the government health facilities by Pharmaniaga.

“It was a closed tender and this disallowed competition. It is common knowledge that competition will bring down prices,” he charged.

Under Dr Mahathir’s privatisation moves, Dr Jayabalan said the prices of generic drugs also soared, effectively denying lower-income earners access to the medicines.

The proposed 1Care for 1Malaysia healthcare transformation plan is a hot topic of discussion in the public.

It is said that a certain percentage of monthly income is to be contributed by the employees and the employers towards the plan, although the details are still on the drawing board.

First of all, we must distinguish the difference between healthcare and medical care. Healthcare is associated with hygiene, proper diet, exercise, and lifestyle.

What the government could do to improve healthcare is to proliferate the awareness through formal education at the schools and informal education through various means.

The key performance indexes may include the level of awareness among the general public on what is healthy food and what is not, how much food is not considered overeating, how much exercise is essential and practical, how much sleep is sufficient, the level of commitment and habitual changes towards healthcare practices, the reduction of obesity among the public, and the reduction of government spending on subsidised medical care.

Medical care is a poor substitute for healthcare. Free or subsidised medical care gives the people false sense of security and misleads them into neglecting their health until it is too late to find out that even modern medical science is not magic.

There is no free lunch. Ultimately, who pay the bills? Who get the biggest slice of the allocation? Could it be pharmaceutical companies, medical care industries, insurance corporations, bankers, and politicians?

Under the 1Care scheme, if the people are forced to pay and forced to accept a doctor assigned by the government, it is repressive. Many people, whether they are rich or not, do not seek treatment at government hospitals due to the perceived poor service quality, irrespective of the true nature of the services.

After all, it is not the responsibility of the public to grant their trust but for the other party to gain the trust of the public. The tax payers are already subsidising the medical cost of those who use the services of government hospitals.

Even if the 1Care scheme only requires monthly contribution of RM10, it does not give any value to those not using the services and it is not fair. Some people receive medical benefits from their employers, while others subscribe to additional insurance for critical illnesses coverage.

FEB 15 — When the idea of a national health financing mechanism came up in the mid-2000s, the question of how the funding scheme would be implemented caused much concern.

As a journalist then with an interest in public health issues, I followed the arguments made, then observed how the idea of “the rich paying for the poor” disappeared.

Logic suggests that the then-proposed national health financing mechanism — or scheme, as it was also referred to — had gone back to the drawing board. Today, it seems that the same idea has been repackaged under 1 Care.

Rebranding aside, the idea of 1 Care is noble. But the sketchy details are worrying. Why a major announcement is made without being accompanied by proper details boggles me.

And yes, Mr Director-General, Malaysians are sensitive when it comes to parting with their money. How can we not be, when we already contribute to EPF, Socso, income tax, service tax, sin tax and a higher cost of living (my jaw dropped when 10 rolls of toilet paper and three packages of my favourite 3-in-1 coffee chalked up almost RM60)?

The DG had also said that the 11 technical working groups are still studying the 1 Care system and details on the paying mechanism will be revealed in due course. He goes on to say that apart from the RM34 billion set aside, the costs of medical visit and treatments will be borne by a central government agency that will pool contributions by “the government, employer, employee and those self-employed.”

He had said: “Under the idea, we optimise the system, you can choose your doctor and you can go to any clinic, private or government as the costs will be paid by an authority handled by the government… it’s very simple. Say you need to be hospitalised and this system allows you a two-person per ward stay, but if you want one which you don’t want to share, then you have to pay for that option.”

What happens to our insurance commitments? From where I sit, it seems like double payment for a single service. We need answers.

FEB 14 — We observe with concern and interest the recent discussions by the ‘rakyat’ and explanations by the Ministry of Health Malaysia (MOH) in the print and electronic media regarding the planned National Health System Transformation. We agree that there are deficiencies in the present system that need to be addressed and applaud the Director-General of Health’s pledge to engage the ‘rakyat’ and stakeholders in its planning.

There is no denying that the Malaysia’s Health System is acknowledged internationally as being successful in providing health services to the ‘rakyat’. Notable successes include:

1. Reduction in mortality and morbidity and increased life expectancy, rising from 56 yrs for male in 1957 to 72 years in 2006; and 58 yrs for females to 76 years correspondingly. Infant mortality rate is comparable to developed countries.

2. An equitable public sector and universal access to comprehensive treatment; where everyone has access to medical treatment up to tertiary level at a nominal fee; and for the poor for free.

3. An effective Public Health Service focused on health promotion and disease prevention.

4. An efficient and effective rural health service; this has been used as a model for other developing countries by WHO

All these were achieved with a total health expenditure amounting to 4.8 per cent of GDP; with the government spending less than 3 per cent of GDP. This is way below that recommended by WHO which is 7.6 per cent.

While the mooted 1Care health system may have some benefits, taxpayers are finding it difficult to trust the government with billions of ringgit in funds that the reform will create through taxation, said Dr Xavier Jeyakumar, the Selangor exco member in charge of health.

The government, Jeyakumar said, is already dipping its hands into the Employees’ Provident Fund (EPF) for RM1.5 billion to finance its low-cost housing loan scheme and there is no guarantee that it will not do the same in the case of 1Care.

“How big is this fund? This fund is huge. It can go on an equal standard of the EPF over the years because it goes into the billions (of ringgit) every year, that’s how big it is,” he told a 1Care healthcare reform forum in Petaling Jaya yesterday.

Under 1Care scheme, employees and employers will be taxed for a social health insurance scheme with no option to opt out, but the government will also contribute to the fund.

Jeyakumar said that the country’s abysmal record on privatisation is not inspiring confidence in the government’s sincerity to reduce healthcare cost with 1Care.

“We have such a poor track record of privatisation because cronyism came in, and privatisation became ‘piratisation’,” he said.

Giving an example, Jeyakumar said drugs that cost five sen a tablet are being sold to public hospitals at 25 sen each by private companies, with which the government has signed a contract for 15 years.

“If you are sincere about bringing change to the healthcare system in this country, we welcome it, but we want you to be transparent, we want you to be open and hold discussions with all stakeholders,” he said.

Critics have complained that the scheme is shrouded in secrecy, but Health Minister Liow Tiong Lai said last Saturday that the plan is still in its infancy.